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Terms and Policy

Declaration of Practices and Procedures
Greetings, and welcome to HOPE Counseling. The goal of HOPE Counseling is to provide affordable, professional, counseling services to those seeking therapy. I want to personally thank you for allowing me the opportunity to serve you. I hope that this information will aid you in making an informed decision concerning the services that we provide.

Qualifications. I hold a Master of Science in Community Counseling from Mercer University along with a Master of Divinity from Mercer University and a Bachelor of Arts (dual degree) in Psychology and Sociology. I am licensed as a LPC with the Georgia Composite Board of Professional Counselors and a Nationally Certified Counselor through NBCC: National Board of Certified Counselors. I hold an additional licensure as a Distance Credentialed Counselor.

Experience/Expertise. During my years of training, my studies in psychotherapeutic counseling have been complemented through an extensive amount of hands-on work with a wide range of clients, emphasizing work with adolescents and adults. I have worked with individuals, couples, and families in both inpatient and outpatient clinical settings dealing with a wide range of counseling issues. I’m a certified stepfamily specialist. Some of these issues include, but are not limited to:


Anger Management
Anxiety
Depression
Divorce
Grief
Attention Deficit Hyperactivity Disorder
Obsessive Compulsive Disorder
Stepfamily Issues
Substance Abuse
Stress
Faith based Counseling
Marital and Family Problems
Women’s issues

I specialize in working with family issues, as well as individual issues. I must clarify though that I am not a medical doctor and cannot prescribe medication of any kind, however, I will need a complete list of any medications a client is currently taking. If there’s an indication that medical treatment is needed, then I will encourage the client to have a complete physical examination if they have not had one within the past year. If I am unreachable in the case of an emergency, I encourage you to seek help through hospital emergency room facilities or by calling 911.

Therapeutic Relationship. The process of therapy is a learning experience that seeks to help the client come to a better understanding of themselves and others. People tend to seek counseling because their own individual or family’s lives’ are not functioning at the best level. As the counselor, my goal is to join with the client as a team to jointly discover the solution.

Within the therapeutic process there are several steps:

1. Exploring your reasons for coming to therapy. This is where I will need to get to know you, how you view yourself, and the quality of the relationships that you have with others. I will always approach you with complete honesty, openness, and sincerity so that we can make the most of this process. I will listen very carefully, giving my total undivided attention to you and assist you in your communication with both myself and others who may be involved.

2. After we have collected all sufficient background information, we will begin to collaborate, choose and set specific goals and objectives. We will then develop a treatment plan that outlines these goals and objectives. You as the client have the right to discontinue therapy if you feel it necessary, due to such reasons as: successful completion and achievement of set goals, personal reasons, and/or the need to continue therapy with another mental health professional.

3. The kind of therapy that I use will depend greatly upon any presenting problems that may be addressed. The different kinds of therapy that I use range from but are not limited to the following therapies listed: solution-focused, existential, Rogerian, Adlerian, cognitive-behavioral and somatic. The nature of my views and beliefs are centered on holistic health recognizing a person’s spiritual, mental and physical aspects. I will never force my personal beliefs and faith upon any individual seeking help under any circumstances.

Confidentiality. All of our sessions will be held in complete confidentiality. I will not disclose to anyone outside this therapy setting any of the content of our sessions. Please note for our sessions due to security in the building it is monitored via a surveillance equipment outside the front door and inside the main office. This information cannot be released without your consent unless there is a legal limitation. If this is a concern please advise me and we can arrange counseling sessions in another area. The cameras run continuously, 24 hours per day, seven days a week. There may arise situations wherein the recorded material is necessarily used in the reporting and investigation of theft, assault, and other reportable incidents. During these investigations, your privacy as a patient may be compromised. If the recorded material is every used in the reporting and investigation of reportable incidents, documentation will be made of the person who view the recorded segments of recorded material will be notified that they were present in the viewed segments. However, I cannot guarantee the confidentiality of those family members and/or significant others that may participate in therapy with us. The only time that confidential information may be released, in accordance with state law is:
1. The client signs a written release of information indicating informed consent to such release.
2. The client expresses serious intent to harm their self or someone else.
3. There is evidence or reasonable suspicion of abuse against a minor child, elderly person (65 years or older), or dependent adult.
4. A court order is received directing the disclosure of information.

Client Responsibilities. In agreement with my responsibilities that I have laid out, it is also agreed upon and expected that the client shall make a good-faith effort at personal growth and interact within the counseling process. Any suspension, termination, or referral may be initiated by either the client or the counselor at any time. These decisions shall be discussed between the client and counselor concerning whether the client’s needs would be better met with another counselor if there is disinterest or lack of commitment to counseling, or if there is any unresolved conflict or deadlock between the client and counselor. Clients coming to this office that are already being seen by another mental health professional must notify me of this and obtain permission from their current therapist before I will be able to work with them. Also, in the case of working to resolving relationship problems between couples, each individual agrees not to subpoena me for testimony in the event that court proceedings develop at a later date, due to the conflict of interest.

Potential Counseling Risks. During the course of therapy, there are numerous benefits that the client will gain as a result; however, there are some risks. These risks may include such things as the experience of intense and unwanted feelings, including: fear, anger, anxiety, sadness, or guilt. Please remember that these feelings may be natural and normal and are an important part of the therapy process. Other risks and/or results of therapy might include: the surfacing of hidden traumatic memories, confronting disturbing thoughts and/or beliefs, encountering major life decisions such as choices to reconcile or separate from other family members and changes in employment settings. I am more than happy to talk to you about any concerns you have regarding these potential risks, so do not hesitate to ask.

Fees and Length of Therapy. The standard fee for a 50-minute session is $120.00. Fees may range differently based upon amount and method of reimbursement by your given insurance company. Payment is due at the time of service to HOPE Counseling unless prearranged in writing. Clients will be charged for appointments that are broken or canceled without 24-hour notice. Payment is accepted from insurance companies that I am a network provider for. The average length of therapy tends to range from 8 to 10 sessions.

Questions. Please feel free at any time to ask questions about the content of my declaration statement or anything it has not addressed. It is your right to ask me these questions and you are entitled to a complete explanation. I am required by state law to adhere to a Code of Conduct for Licensed Professional Counselors, which is determined by the Georgia Licensing board. Board. Board. A copy of this Code can be made available upon request.
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Counseling Policies
Counseling Sessions

During your first session we will work with you to determine how we can best meet your needs. If we agree, future appointments will be scheduled. Sessions are 50 minutes in length beginning from the scheduled appointment time.

Fees

The standard fee per counseling session is $120.00. Fees are due at the time of service unless prearranged through reimbursement by an approved third party. If you have a prearranged agreement for session payments through an approved third party then you will not be directly responsible for therapy session fees, however this does not apply to other fees you may incur such as: late cancellation fees, physician and/or legal letter fees and/or official written report fees.

Acceptable means of payment will be through cash, check, credit card, money order, or PayPal. All checks and/or money orders must be made out to: Marquita Johnson”. ***If you cannot afford the standard fee for counseling sessions and would like to inquire as to whether you qualify for our income-based sliding-fee scale, then you may do so with your Therapist. ***Please note that for any checks returned due to NSF (non-sufficient funds) reasons there will be a $30.00 NSF charge added to the client's account and must be paid in full before further sessions can be rendered.

Cancellations

We understand that occasionally appointments may need to be canceled, therefore we ask that you notify us as soon as possible when you know that you need to cancel. This provides an opportunity for that counseling session time to be available for someone else. If you do not notify us of your cancellation within 24 hrs of your scheduled appointment it is our policy to bill you for at the entire session fee. If you do not attend a scheduled appointment without proper notification we reserve the right to receive the above mentioned fee before scheduling future appointments.

Emergencies

In some extreme situations, you may need to talk to you Therapist before your next scheduled session. If the need cannot wait until the next scheduled session, please leave a message for your therapist and they will attempt to return your call within 24 hours or the next business day. If you need assistance after hours, weekends, or in an emergency, call the following provider for crisis intervention or go to your local hospital emergency room or dial 911:

National Hopeline Network 1-800-442-HOPE

Georgia Crisis Line 1800-715-4225

I agree to the aforementioned counseling policies of HOPE Counseling LLC and will comply with these policies during the course of treatment by Marquita Johnson.
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Consent to use and disclose your health information
When I examine, assess, give diagnostic impressions, treat, or refer you I will be collecting what the law calls Protected Healthcare Information (PHI) about you. I will use this information to decide what treatment is best for you and how to provide any treatment to you. The information may also be needed to arrange payment for your treatment or for other business or government functions.

By signing this form you are agreeing to let me use your information at this agency and send it to others as referenced in the Privacy Practices Statement. The Notice of Privacy Practices explains in more detail your rights and how I can use and share your information. Please read the Privacy Practices statement before signing this form.

If you do not sign this consent form agreeing to what is in my Notice of Privacy Practices I cannot treat you.

In the future I may change how I use and share your information and I may change my Notice of Privacy Practices. If I do change it, you can get a copy by contacting me at 678-865-4343.

If you are concerned about some of your information, you have the right to ask me to not use or share some of your information for treatment, payment or administrative purposes. You will have to tell me what you want in writing. Although I will try to respect your wishes, I am not required to agree to these limitations. However, if I do agree, I promise to do as you have asked.

After you have signed this consent, you have the right to revoke it (by writing a letter to me and/or Ms. Marquita Johnson, LPC, Owner/Operator of HOPE Counseling, LLC., stating you no longer consent) and I will comply with your wishes about using or sharing your information from that time on, however there is the possibility that I may have already used or shared some of your information and cannot change that.
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